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Viral Hepatitis

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Treatment Side Effects Chart

Hepatitis C Treatment Side Effects Management Chart

If the clinic is closed and you are having a serious side effect (such as chest pain or severe depression), please seek immediate medical attention.

Side Effect Management Tips
Side EffectManagement Strategies

*Generic versions are usually less expensive than brand-name products. Brand names are provided as examples only, and their inclusion does not indicate an endorsement by the Veterans Health Administration or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Fever/chills
  • Try injecting interferon at bedtime if fever/chills develop 1-3 hours after the interferon injection
  • Take acetaminophen (Tylenol*) about 30-60 minutes before weekly interferon injection
  • Take acetaminophen (Tylenol*) 1-2 tablets prior to interferon injection and repeat 4-6 hours later if needed up to a maximum of 2,000 mg/day. Thus, do not exceed 6 tablets/day of 325 mg or 4 tablets/day of 500 mg acetaminophen (Tylenol*).
  • Use ibuprofen [Advil*, Motrin*] or naproxen [Aleve*] if approved by your provider and you do not have cirrhosis
  • Try a cool sponge bath, ice pack or cold pack when you have a fever
  • Use extra blankets and clothes when you have the chills
  • Notify your provider if your temperature is above 101°F for more than 24-48 hours
Muscle and body aches
  • Try injecting interferon at bedtime if body aches develop 1-3 hours after the interferon injection
  • Take acetaminophen (Tylenol*) about 30-60 minutes before weekly interferon injection
  • Take acetaminophen (Tylenol*) 1-2 tablets prior to interferon injection and repeat 4-6 hours later if needed up to a maximum of 2,000 mg/day. Thus, do not exceed 6 tablets/day of 325 mg or 4 tablets/day of 500 mg of acetaminophen (Tylenol*).
  • Use ibuprofen [Advil*, Motrin*] or naproxen [Aleve*] if approved by your provider and you do not have cirrhosis
  • Try low-impact exercise such as walking or low-impact aerobics as directed by your provider
  • Maintain adequate fluid intake (at least six to eight non-caffeinated 8-oz glasses/day)
  • Apply warm moist heat or massage areas
Headaches
  • Maintain adequate fluid intake
  • Take acetaminophen (Tylenol*) or ibuprofen (Motrin*, Advil*) as directed by your provider
  • Keep lights dim, wear sunglasses or stay in darkened rooms
  • Try to get plenty of rest
Fatigue
  • Try low-impact exercise such as walking or low-impact aerobics as directed by your provider
  • Maintain adequate fluid intake (may have a caffeinated beverage in the morning)
  • Take a short nap during the day
  • Lessen your work schedule if possible
  • Eat well-balanced meals every day
Depression
  • Talk to your provider about your symptoms and medications that might help
  • Always discuss thoughts of harming yourself or someone else with your provider
  • Go to the nearest emergency room if you are in danger of harming yourself or others
  • Do mild to moderate exercises at least 3 times/week as directed by your provider
  • Join a hepatitis C support group
Anxiety and irritability
  • Talk to your provider about your symptoms and medications that might help
  • Always discuss thoughts of harming yourself or someone else with your provider
  • Go to the nearest emergency room if you are in danger of harming yourself or others
  • Do mild to moderate exercises at least 3 times/week as directed by your provider
  • Try relaxation techniques such as deep breathing, taped exercises, yoga, Tai Chi or meditation
  • Avoid stimulants like caffeine and maintain adequate fluid intake
  • Join a hepatitis C support group
Insomnia
  • Go to sleep and wake up at the same time every day
  • Do not read or watch TV in bed
  • Limit daytime naps
  • If ribavirin makes you jittery, take at 4-5 pm instead of before bedtime
  • Limit fluid intake for 2 hours before bedtime to avoid having to get up to go to the bathroom
  • Avoid caffeinated products, especially in the afternoon and at night
  • Avoid heavy meals close to bedtime
  • Take warm baths, read or listen to music, get a massage
  • Try a glass of warm milk (contains tryptophan, a natural sleep agent)
  • Diphenhydramine (Benadryl*) or other medications may be recommended by your provider
Dry mouth or mouth ulcers
  • Brush teeth frequently, especially after eating
  • Avoid mouthwash containing alcohol
  • Drink plenty of water or use ice chips or sugar-free lemon drops
  • Other medications may be needed for mouth sores/ulcers
  • Ask your provider about medications that may help
Bad taste in mouth
  • Use sugar-free lemon drops or real lemon wedges
  • Eat a small amount of yogurt, 1/2 hour before meals or eat dark chocolate (monitor your glucose levels if you have diabetes)
  • Drink lemonade or cranberry juice (monitor your glucose levels if you have diabetes)
  • Eat food cold or at room temperature
  • Brush teeth frequently, especially after eating, to eliminate metallic taste
  • Use plastic utensils if experiencing metallic taste
Poor appetite
  • Eat smaller, more frequent (4-6) meals throughout the day
  • Drink protein drinks (Carnation Instant Breakfast*, Ensure* or Boost*)
  • Eat snacks with protein (cheese, peanut butter, eggs)
  • Eat whatever appeals to you even if not hungry. Eat a variety of foods
  • Walk before a meal
Nausea and vomiting
  • Take ribavirin with food
  • Eat small meals
  • Avoid foods or smells that trigger nausea. Try eating cold foods and avoiding cooking smells
  • Eat healthy foods. Avoid greasy, spicy, acidic or sweet foods
  • Try eating ginger in ginger tea, ginger ale or gingersnaps
  • Eat some crackers or dry white toast if you feel sick in the morning
  • Over-the-counter antacids or other medications may be recommended by your provider
Diarrhea
  • Eat more soluble fiber like Bananas, white Rice, Applesauce and white Toast (the "BRAT" diet)
  • Avoid foods that are spicy or acidic (like citrus)
  • Avoid dairy products up to several days after diarrhea resolves
  • Maintain adequate fluid intake (at least six to eight 8-oz glasses/day)
  • Your provider may recommend loperamide (Imodium*) or methylcellulose (Citrucel*) or psyllium (Metamucil*)
Dehydration
  • Increase intake of water or non-caffeinated beverages
  • Water down juices, Gatorade* or Crystal Light*
  • Avoid caffeinated beverages
Cough
  • Increase intake of water or non-caffeinated beverages
  • Use a humidifier
  • Try sugar-free hard candy or cough drops
Dry skin/ rashes
  • Avoid long, hot showers or baths
  • Use moisturizing soaps (Dove*, Oil of Olay*, Cetaphil*)
  • Use moisturizing lotion after showers (Aquaphor*, Absorbase*, Lac-Hydrin*)
  • Use mild unscented laundry detergents and avoid fabric softeners
  • Use sunscreen
  • Try rubbing or pressing on the itchy areas rather than scratching
  • Use petroleum jelly on dry, itchy areas. Your provider may recommend other agents to help
Hair thinning or hair loss
  • Avoid harsh hair products such as dyes, perms, gels, sprays and mousses
  • Use a mild shampoo such as baby shampoo
  • Avoid braiding hair; use a wide-tooth comb or soft brush
  • Wear a cap, scarf, turban or wig
Anal-rectal discomfort (hemorrhoids, rectal itching or burning)
  • To relieve anal itching, try short-term topical corticosteroid
  • To relieve nighttime itching, try over-the-counter antihistamines before bedtime
  • Your doctor can prescribe drugs to loosen stools
  • If you are constipated, eat high-fiber foods (such as whole grains, dried beans and peas, and fruits)
Injection site reactions
  • Before injecting, warm your medicine by gently rolling the syringe in your hands for a minute
  • Rotate/alternate your injection site - thigh, upper arm and abdomen. If you are thin, use the thigh area
  • Do not inject into an area that is irritated, bruised or red
  • Do not rub injection site
  • Apply a cold pack
  • Your provider may recommend applying hydrocortisone cream or other medications to help